The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64107

Heather M. Brandt, PhD, CHES¹, Kathryn J. Luchok, PhD², Ann L. Coker, PhD³, Jill M. Abbott, MPH², and Irene Prabhu Das, MPH⁴. (1) Prevention Research Center, University of South Carolina, Arnold School of Public Health, 730 Devine Street, Columbia, SC 29208, 803-777-7676, hbrandt@sc.edu, (2) Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 800 Sumter Street HESC 216, Columbia, SC 29208, (3) School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler, PO Box 20186, Houston, TX 77225, (4) Division of Cancer Prevention & Control, SC Department of Health and Environmental Control, PO Box 101106, Columbia, SC 29211

BACKGROUND: Almost 4 million U.S. women will have abnormal Pap tests this year, yet rates for follow-up care are less than ideal. Patient-clinician communication regarding abnormal results can play a role in whether women return for timely and often life-saving follow-up. METHODS: Thirty clinicians contracted to provide breast and cervical cancer screening services to income-eligible women completed a tape-recorded, telephone interview. The 26-item questionnaire addressed on-site clinical services, counseling practices, and perceptions of why some women do not return for follow-up care. Following verbatim transcription, data were analyzed using the constant comparison method. RESULTS: Women are told of abnormal Pap tests via telephone, letter, and/or in person during office appointments. To reduce anxiety, some clinicians attempt to reassure women when giving results. What women are told varies by clinician and often depends on patient history and severity of abnormality. Most clinicians discuss abnormal Pap tests in the context of “abnormal cells.” While conducting the initial Pap test, some clinicians will tell women about what may happen if the Pap is abnormal. Many clinicians believe they are doing everything possible to promote timely follow-up. CONCLUSION: How women are informed and what they are told about test results may be an important factor in determining whether women decide to obtain follow-up care. Insights into improving patient-clinician communication may enhance timely follow-up care and ultimately lead to fewer cervical cancer cases.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to: (
• Describe methods of communication by which clinicians communicate abnormal Pap test results; (
• Recognize the relationship between poor clinician communication of abnormal Pap tests and receipt of timely follow-up care among women; and (
• Discuss the importance of clinician communication regarding abnormal Pap tests on women's health.

Keywords: Cervical Cancer, Women's Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.